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General NPI Number Information
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NPI Number | 1376766576
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Entity Type | Organization
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Legal Business Name | MOBILE CHIROPRACTIC SERVICES, PC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 106 N DUNTON AVE
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City | EAST PATCHOGUE
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State | NY
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Zip | 11772-5542
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Country | US
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Telephone | 631-664-6492
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Fax |
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Provider Business Mailing Address
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Address Line | 106 N DUNTON AVE
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City | EAST PATCHOGUE
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State | NY
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Zip | 11772-5542
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Country | US
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Telephone | 631-664-6492
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Fax |
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Authorized Official
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Title or Position | DC
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Name | HAROLD ROHER
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Credential | DC
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Telephone | 631-664-6492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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